审查南蒂罗尔的经验:根据第77/2022号部长级法令实施意大利初级保健改革中的数字健康采用和劳动力问题。

Christian J Wiedermann, Angelika Mahlknecht, Verena Barbieri, Dietmar Ausserhofer, Barbara Plagg, Carla Felderer, Pasqualina Marino, Adolf Engl, Giuliano Piccoliori
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引用次数: 0

摘要

背景:部长法令(D.M.) 77/2022旨在通过建立社区卫生中心和整合数字工具来改革意大利的初级保健系统,以解决医疗保健获取差距和劳动力短缺问题。本次审查重点关注南蒂罗尔博尔扎诺自治省的脆弱性评估工具、数字卫生创新和劳动力挑战,强调专业间信任和协作问题。方法:采用SANRA清单指导的叙述性自定义审查方法,本研究综合了来自PubMed、官方健康网站和南蒂罗尔地区脆弱性、劳动力动态、跨专业协作和数字基础设施的区域调查的结果。结果:全科医生(gp)表现出较高的专业动机,但对协作护理模式中的自主性和行政负担表示担忧。全科医生和专家之间的信任问题阻碍了员工队伍的凝聚力和护理协调,突出了结构化跨专业沟通的必要性。虚弱评估,如prism -7工具,将超过33%的75岁及以上社区居民确定为虚弱,需要有针对性的干预措施。由于劳动力短缺和基础设施的限制,数字医疗的采用,特别是电子健康记录和远程医疗的采用进展缓慢。结论:在南蒂罗尔成功实施D.M. 77/2022需要解决劳动力挑战,改善专业间信任,扩大数字基础设施,并将脆弱性评估结果纳入护理战略。这些措施对于建立一个更有韧性、更公平和更有效的初级卫生保健系统至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining South Tyrol's Experience: Digital Health Adoption and Workforce Issues in Implementing Italy's Primary Care Reform Under Ministerial Decree No. 77/2022.

Background: Ministerial Decree (D.M.) 77/2022 aims to reform Italy's primary care system by establishing community health centres and integrating digital tools to address healthcare access disparities and workforce shortages. This review focuses on frailty assessment tools, digital health innovations, and workforce challenges in the Autonomous Province of Bolzano, South Tyrol, emphasising interprofessional trust and collaboration issues. Methods: Using a narrative custom review approach guided by the SANRA checklist, this study synthesised findings from PubMed, official health websites, and regional surveys on frailty, workforce dynamics, interprofessional collaboration, and digital infrastructure in South Tyrol. Results: General practitioners (GPs) exhibited high professional motivation but expressed concerns about autonomy and administrative burdens in collaborative care models. Trust issues between GPs and specialists hinder workforce cohesion and care coordination, highlighting the need for structured inter-professional communication. Frailty assessments, such as the PRISMA-7 tool, identify over 33% of community-dwelling individuals aged 75 years and older as frail, necessitating targeted interventions. Digital health adoption, particularly electronic health records and telemedicine, is slow because of workforce shortages and infrastructure limitations. Conclusions: The successful implementation of D.M. 77/2022 in South Tyrol requires addressing workforce challenges, improving interprofessional trust, expanding digital infrastructure, and integrating frailty assessment findings into care strategies. These measures are critical for achieving a more resilient, equitable, and effective primary healthcare system.

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